One of the classes I am taking this semester (Biopsychosocial Perspectives on Physical Activity) has helped me to better understand why Bates’ approach to vision is different and more complete than the opinion held by the majority of optometrists and ophthalmologists. As a starting point, Bates viewed vision with a biopsychosocial model while most eye doctors viewed, and still view, vision with the biomedical model.
I’ll first describe what the models represent. The biopsychosocial model of health is comprised of three parts: “bio” refers to biological/physiological processes such as physical injuries and bacterial infections; “psycho” refers to psychological/mental/behavioral processes such as emotions, cognitions, and motivations; “social” refers to one’s relationships with other people or groups. Basically, this model says that one’s health or illness is prevented/maintained/caused by a combination of biological, psychological and social factors; this model supports a relationship between the mind and body. On the other hand, the biomedical model (which focuses on illness) says an illness is caused by a single biological factor; this model claims that the mind and body are separate. Just at a definitional level, it is easy to see how these models are significantly different.
These two models further explain the differences in how vision conditions are treated. Bates treated people by addressing the physical, mental, and social factors that influence one’s vision.
- Biological factor: Bates believed that imperfect vision was directly caused by strained (external) eye muscles, which caused the eyes to be misshapen. To treat the physical causes of poor vision, Bates addressed the mental and social factors of vision. These two latter factors indirectly caused imperfect eyesight.
- Psychological factor: Bates believed that the direct biological causes of poor vision were caused by mental strain. To treat the mental causes of imperfect sight, Bates taught his patients to relax their minds so that one thing was thought of best (central fixation of the mind). Some relaxation methods he taught were swinging, shifting, palming, using the imagination and using the memory.
- Social factor: Bates believed that the indirect mental causes of imperfect vision were influenced by one’s relationship with other people. One example of this was a story from Bates’ book which told of a school boy who could not see the chart clearly when his teacher was standing behind him and telling him to “mind what he was about”. When Bates asked the teacher to leave the room, the boy was relieved of that stress and could read the chart perfectly. In order to treat the social factors of poor sight, Bates either had the anxiety-causing person leave the room and/or helped the patient to not become stressed out by the thought or presence of the negative person.
Conventional eye doctors follow the biomedical model that attributes all vision conditions to physical factors.
- Biological factor: An eye has poor vision because it is physically elongated or shortened (horizontally), and/or the ciliary muscles have deformed the natural curve of the lens. This change in shape is cause by an irreversible physiological process (which is not caused by the external eye muscles). Since the vision cannot be improved, concave or convex lenses (glasses, contacts, surgery) can be used to adjust where the rays of light focus inside the eye.
With all this said, it is clear that the biopsychosocial model is more complete than the biomedical model. Current research strongly supports that biological, psychological, and social factors can influence one’s health. Furthermore, I think personal experience also confirms the veracity of the former model. For example, a stomach ache can be caused by a variety of things. A physical cause could be improperly cooked food (food poisoning); however, anxiety about an exam or strong anger at another person can also give one a stomach ache.
While it may seem disheartening that most eye doctors currently follow the biomedical model, I think there is hope for the future of vision treatment. As more and more research supports that mental and social factors have a strong influence on health and illness, this new way of thinking may spread to the fields of optometry and opthalmology. Perhaps in the future, eye doctors and vision researchers will look back and see that Bates’ approach to vision treatment was correct all along. 🙂